Journal of Nippon Medical School: Vol.71 No.3 page.209

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ArticleTitle A Case of Hepatocellular Carcinoma with Situs Inversus Totalis

AuthorList Daisuke Kakinuma¹, Takashi Tajiri¹, Hiroshi Yoshida¹, Yasuhiro Mamada¹, Nobuhiko Taniai¹, Youichi Kawano¹, Yoshiaki Mizuguchi¹, Tetsuya Shimizu¹, Tsubasa Takahashi¹, Koho Akimaru¹, Takumi Aramaki² and Teruo Takano²

Affiliation ¹Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine
²Department of Medicine I, Nippon Medical School

Language JA

Volume 71

Issue 3

Year 2004

Page 209-212

Received April 2, 2003

Accepted January 21, 2004

Keywords hepatocellular carcinoma, situs inversus totalis

Abstract
We report a case of hepatocellular carcinoma with situs inversus totalis treated by hepatectomy. A 70-year-old asymptomatic female with hepatocellular carcinomas in segments 5, 6 and 8 underwent transarterial embolization in the department of medicine. However, hepatocellular carcinoma in segment 8 relapsed, and she was referred to the department of surgery. Laboratory tests revealed elevation of serum PIVKA2 level (4,690 ng/mL). Angiography revealed tumor stain in segment 8, 3 cm in diameter. No aberrant vessels were detected on angiography. The operator stood on the patient's left, and partial hepatectomy could be performed safety after careful examination of the anatomy. Although aberrant vessels are detected in many patients with situs inversus totalis, operations can be performed safely on them with sufficient understanding of the anatomy.

Correspondence to Daisuke Kakinuma, Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan

ArticleTitle	A Case of Hepatocellular Carcinoma with Situs Inversus Totalis
AuthorList	Daisuke Kakinuma¹, Takashi Tajiri¹, Hiroshi Yoshida¹, Yasuhiro Mamada¹, Nobuhiko Taniai¹, Youichi Kawano¹, Yoshiaki Mizuguchi¹, Tetsuya Shimizu¹, Tsubasa Takahashi¹, Koho Akimaru¹, Takumi Aramaki² and Teruo Takano²
Affiliation	¹Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine ²Department of Medicine I, Nippon Medical School
Language	JA
Volume	71
Issue	3
Year	2004
Page	209-212
Received	April 2, 2003
Accepted	January 21, 2004
Keywords	hepatocellular carcinoma, situs inversus totalis
Abstract	We report a case of hepatocellular carcinoma with situs inversus totalis treated by hepatectomy. A 70-year-old asymptomatic female with hepatocellular carcinomas in segments 5, 6 and 8 underwent transarterial embolization in the department of medicine. However, hepatocellular carcinoma in segment 8 relapsed, and she was referred to the department of surgery. Laboratory tests revealed elevation of serum PIVKA2 level (4,690 ng/mL). Angiography revealed tumor stain in segment 8, 3 cm in diameter. No aberrant vessels were detected on angiography. The operator stood on the patient's left, and partial hepatectomy could be performed safety after careful examination of the anatomy. Although aberrant vessels are detected in many patients with situs inversus totalis, operations can be performed safely on them with sufficient understanding of the anatomy.
Correspondence to	Daisuke Kakinuma, Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan